12 Responses to “Ernst on Homeopathy”

Great article. I think the distinction between science-based medicine (SBM) and evidence-based medicine (EBM) is an important one. As you have described here and elsewhere, EBM is associated with a variety of issues, in particular the emphasis on more research (‘more well designed large RCTs needed’ etc.) which is often unnecessary purely on the grounds of non-existent prior plausibility. This is expensive, time consuming and doesn’t take into account the likelihood of false positives from poorly and even well-designed trials muddying the waters.

However, anyone I know who is actively involved in research either has not heard of SBM or is typically unaware of the distinction between SBM and EBM. For example, searching for ‘science based medicine’ on google or pubmed doesn’t really bring up any results for published academic articles, apart from those about EBM.

Is there any intention to outline the position of science based medicine in the academic literature in the same way as Sackett and colleagues influential articles did for EBM (eg. Evidence based medicine: what it is and what it isn’t, (1996) BMJ) or is this not a plausible option? I personally think a position statement which outlines the theoretical and methodological goals of SBM and how they build upon and correct upon some of the limitations of EBM would be a valuable contribution to the research literature.

I have to agree with carbon unit, part of what’s muddying the water these days is the fact that homeopathy is replacing “natural” when it comes to certain products. I notice on occasion a lot of products using the label that obviously aren’t just water.

I know this is an old quibble that gets trotted out time after time, but once again, my eye twitched a little bit when I saw the term “skeptic” being used to describe someone “rejecting” something for one reason or another.
I realize these anecdotes confirm my own bias, but that bias is that the term skeptic only describes the very first part of what skepticism really entails: Don’t buy into a claim before looking into it. Then you go through all of the steps you need to in order to evaluate evidence, plausibility, ect ect.

I know there have been other attempts at finding a different name… but gah!

I now use “Bayesian Skeptic” or “Bayesian Rationalist”. This leads into a discussion of Bayes theorem and how prior probability feeds into evaluating dubious claims in the context of other explanations.

Three interesting points to consider about homeopathy: it is a “medicine” that is unlikely to be harmful due to the dilution method, very cheap to produce (99.9999…% of sugar), and effective, in the sense that a placebo one believes in is effective for many medical problems peoples have.

I wonder, if, at least in France, homeopathy hasn’t been officially approved as a medicine just to give a cheap and inoffensive answer to public request for “alternative” medicine, a placebo that is as effective as any other, but cheaper and less dangerous than many. Even if it cost a bit of public money, it’s likely a better option than misuse of “conventional” drugs or many other “alternative” stuff, that could cost far more in consequences.

“I wonder, if, at least in France, homeopathy hasn’t been officially approved as a medicine just to give a cheap and inoffensive answer to public request for “alternative” medicine, a placebo that is as effective as any other, but cheaper and less dangerous than many. Even if it cost a bit of public money, it’s likely a better option than misuse of “conventional” drugs or many other “alternative” stuff, that could cost far more in consequences.”

That’s most likely the case just about everywhere. I’ve seen interviews and articles where directors literally say we’re bringing it in because of the money it generates. No discussion about efficacy. The important thing to understand here is that in the end it’s the wrong answer. Unproven, or methodologies proven not useful should not be part of a legitimate healthcare system.